This substitute makes several changes to the Missouri Consolidated Health
Care Plan. The substitute:

(1) Increases membership of the board of trustees from 11 to 13 members
(Section 103.008, RSMo);

(2) Requires the board to submit a plan to the General Assembly by
September 1, 2000, regarding state employees in counties without HMO
coverage, allowing those employees to receive medical benefits that are
substantially identical to HMO benefits. The cost for coverage may not
exceed the state's average HMO cost (Section 103.081);

(3) Requires medical benefits to have been continuous, either under a
separate policy for at least 6 months or since the effective date of the
most recent open enrollment prior to the member's termination, in order for
a member's medical benefits to continue after termination from state
employment (Section 103.085);

(4) Prohibits any member agency from participating in the plan for 2 years
after its termination date (Section 103.136);

(5) Recommends that the board implement a health care provider plan period
based upon a fiscal year beginning October 1 of each year, rather than the
calendar year (Section 1); and

(6) The word "instrumentality" is removed from the definition of
"participating member agency" (Section 103.003(16)).